上顎洞平滑筋肉腫の1例

Leiomyosarcoma in the Maxillary Sinus:A Case Report

　はじめに

　鼻・副鼻腔に発生する悪性腫瘍は大部分が上皮性腫瘍で，非上皮性腫瘍は比較的少ない。中でも平滑筋肉腫は極めて少なく，われわれが検索し得た限り，本邦においてはこれまでに16例の報告^1〜16）をみるに過ぎない。

　今回われわれは，上顎洞原発の平滑筋肉腫症例を経験したが，本例は手術療法，化学療法，放射線療法に抵抗し，予後は不良であった。本例の治療経過を若干の文献的考察を加えて報告する。

Leiomyosarcoma in the sinonasal region is very rare.

A 70-year-old female presented with leimyosarcoma arising from the maxillary sinus. The patient complained of the left nasal obstruction and recurrent epistaxis. CTexamination revealed a large tumor in the left maxillary sinus extending into the orbit, pterygoid muscles and posterior paranasal sinuses. Immunohistological study of the excised specimen showed positive staining for vimentin and a-smooth-muscle actin. With these find-ings, leiomyosarcoma was diagnosed. She underwent surgical resection including the left orbital content fol-lowed by chemotherapy and irradiation. However, she died of multiple distant metastases six months after her admission to our hospital. Clinical features of this tumor were briefly reviewed.